Liver abscess in early infancy is uncommon, needs a high index of suspicion for diagnosis and carries a high mortality. It presents most frequently by a fulminant course, generalised sepsis and multiple metastatic abscesses. An underlying predisposing factor is usually attributed in nearly all cases reported to date. These include prematurity, low birth weight, umbilical catheterisation (UC), administration of hypertonic dextrose or total parenteral nutrition via UC, exchange transfusion, blood culture proven sepsis, necrotising enterocolitis, antecedent abdominal surgery, birth asphyxia, omphalitis and underlying immunodeficiency. We present three cases of early infantile liver abscesses without any identifiable predisposing factor despite extensive work-up to search for such. Early recognition and management led to a favourable outcome in all our patients.
BACKGROUND AND OBJECTIVES :- The present study was attempted to nd out the role of conventional and newer modalities for the treatment and rehabilitation and prevention of complication of diabetic foot patients. MATERIALAND METHOD:-. 50 patients of diabetic foot admitted in civil Hospital,ahmedabad were studied within two years from 2018 to 2020 and careful assessment of history, clinical ndings, investigation, management and follow-up of these patients done. RESULT:-According to my study, Diabetic foot is common in males & 51-60 years of age group,in smokers, in lower socio-economic class, with average duration of 8 to 10 years of diabetes melitus, most common type of lesion was abscess,most common site was forefoot, mostly was of neuropathic in nature & mostly managed by debridement. Mean hospital stay was 1 week to 1 month. CONCLUSION:- Patient education and awareness regarding good sugar control of diabetes, use of proper antibiotics, adequate debridement and proper dressing ;with eusol, betadine hydrogen peroxide along with newer dressing methods like vacuum dressing found to be effective. Amputation done only for gangrene and proper rehabilitation method carried out for these patients.
Modern management of liver abcess include a combination of percutaneous Needle aspiration or percutaneous Catherter drainage along with intravenous antibiotic .Liver abcess is common disease in india, if not treated properly can lead to hazardous complication. MATERIAL AND METHOD; This was comparative study of 30 patient from august 2018 to August2020 in civil hospital ahmedabad. Randomization was done and dived into two groups of 25 each and assigned two group as percutaneous Catherter drainage and needle aspiration. Both groups were given intravenous antibiotics for 7 days .Both modalities were performed under guidance of ultrasound imaging. Needle aspiration was repeated for three times and if size of abcess cavity not reduced to half consider as failure of treatment. Effectiveness of treatment measured in term of days to achieve clinical improvement, total/near total resolution of abcess cavity and duration of hospital stay. RESULT; Needle aspiration was successful in 13 out of 15,whereas percutaneous drainage was successful in 14 out of 15.Duration of hospital stay were significantly lower in percutaneous drainage.one patient with needle aspiration developed subcapsular hematoma. CONCLUSION; We can conclude that percutaneous drainage is better modality is better modality as compared to needle aspiration in medium to large size liver abcess. The duration of hospital stay is comparatively lower in percutaneous drainage and days of clinical relief were earlier in percutaneous drainage. This study also verify that both were adequately effective in the treatment of liver abcess. *AIM OF THE STUDY To compare the effectiveness of percutaneous catheter drainage and percutaneous needle aspiration in management of liver abcess.
An enterocutaneous stula (ECF) is an aberrant connection between intra-abdominal gastrointestinal tract and the skin. While great majority are iatrogenic, between 15-25% occur spontaneously. Common causes of spontaneous stula are congenital, infections, inammation, tumour, radiation and ischemia. Mortality associated with ECF has decreased from 40-60% to 15-20% largely attributed to advances in uid, electrolyte, acid-base balance knowledge, administration of blood products, critical care, antibiotic regimen and nutritional management – both enteral and parenteral.
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